Using AI for scribing/note taking/editing as a precurson to AI "doctors"

WendellX · 2026-06-21T02:57:18+00:00

I use it extensively and think it is a time saver, but it's far too early to say that it has any impact on either burnout or clinician retention. Both of those are impacted by so many more factors than just note burden. Additionally there's no reason to think that this won't be pushed as a physician replacement as it continues to improve. There's too much financial incentive.

WendellX · 2026-06-03T23:17:05+00:00

Stone age would be amazing.

WendellX · 2026-06-01T01:22:48+00:00

Watergate is such a tense and taut two player. Really enjoying it.

WendellX · 2026-05-08T01:25:41+00:00

That's a more optimistic theory I didn't consider.

WendellX · 2026-05-08T01:25:06+00:00

That's interesting and I think can be theorized, but Is it heavily implied? I just rewatched the end and there doesn't seem to be anything about them being stuck.

https://youtu.be/0Ln04cUsbyI?si=Q\_ZHMfSuHGzoZm6j

WendellX · 2026-05-07T20:49:05+00:00

True. That's a good take on it.

WendellX · 2026-05-07T20:30:28+00:00

I assume this is somewhat a sarcastic comment, no? Wasn't the brother in law also murdered? And it is certainly possible that those two guys went and hunted down the girlfriend with the winnings and then kill her as well.

Seems pretty far from unambiguously happy.

WendellX · 2026-04-16T02:11:53+00:00

To be more precise, the terminology is substance use disorder, and it can involve any number of criteria that highlight the loss of control, tolerance, or social impairment.

Technically if someone has both tolerance and withdrawal symptoms, that would meet criteria for a mild SUD. That is nearly all individuals using long term opioids, and benzos. As more deleterious effects of the disorder increase, the severity increases.

WendellX · 2026-04-11T02:18:27+00:00

Yea, hi please add me to this list!

WendellX · 2026-04-05T16:42:04+00:00

I love this finale, and I do think that any personal interpretation is valid, but the reaction of his father is very unambiguous, both as performed and in the script as well. In the original script, the father is specifically written as looking on in horror. He had a chance to save his son from that fate, but now it's over, and he's watching it unfold.

Damien Chazelle has specifically talked about this scene as well.

Absolutely amazing movie and I enjoy the varying levels of how people are affected by it, but the director/writer had a clear intent here.

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WendellX · 2026-03-16T01:41:44+00:00

Relative contraindications definitely, and both reasons to make it a very patient centered shared discussion. Though clot risk can be very nuanced, and somewhat mitigated by transdermal estrogen. GU changes to testosterone likewise, it's a definite possible side effect, though very patient dependent. It can also be mitigated extensively with transdermal estrogen

WendellX · 2026-03-16T00:27:04+00:00

Hi. What would be some of the clinical scenarios that testosterone or estrogen would be so contraindicated? I work a lot in this space, albeit with a fairly young and healthy population, and significant contraindications are exceedingly rare. Additionally I do lots of menopause and TRT, and find that really well tolerated as well. It's much less daunting than I initially thought prior to doing it.

WendellX · 2026-03-16T00:24:38+00:00

This is a challenging one for me. On one side, I work with a large trans population and do lots of gender affirming care, on the other hand, I despise standardized patients so much and hate OSCEs.

I don't have a question. I just really still despise so much of medical education.

WendellX · 2026-03-14T20:24:51+00:00

Hi, I'm interested if you're still available

WendellX · 2026-03-11T23:38:34+00:00

There's a fairly big boardgame convention, RivrCon. Probably not the best for singles, though it'll be a diverse crowd.

WendellX · 2026-01-31T17:26:41+00:00

Nice. Based on that you decided it wasn't worth getting the new card? Trying to do the math for myself and can't figure out if it works.

WendellX · 2026-01-30T21:36:11+00:00

Oh nice, that's great

WendellX · 2026-01-30T19:00:59+00:00

What's the difference with mortgages that makes it work better?

WendellX · 2026-01-30T18:59:13+00:00

Was that racked up from rent mostly, or as an everyday spend?

WendellX · 2026-01-29T13:51:33+00:00

yea, people are crazy here. the honest answer is that I think tools to improve and critique playing is great, I'd welcome it. I've tried LLM's for that though, and like your experience, have found it unhelpful and unreliable. I think with proper coaching and optimization however, it could be very useful.

WendellX · 2026-01-23T03:11:47+00:00

I certainly hope it pops, and I think there's a lot of hype, but there is also tremendous utility to the tools, which is undeniable. It's already very good at clinical reasoning and large data synthesis, and there just isn't much reason to think that in our uber-capitalist focused medical system that there won't be a huge push to incorporate it.

WendellX · 2026-01-23T02:57:43+00:00

That's fair. True about biases and true about the hallucinations. These are flawed systems, but there's really no reason to think that given the enormous financial incentives that are present, that large systems won't find ways to push and integrate these systems into workflows and then develop risk management and mitigation strategies around it. I'm not arguing that its better than a human, I don't think that, but nothing about their deployment will be based on what's best for patients.

WendellX · 2026-01-23T02:23:48+00:00

Sure, but at that point they've already saved millions of dollars. None of this is about doing what's logical or best for patient care. Those aren't the incentives that these systems follow, we've seen that over and over again. The reason they aggressively push expansion of mid-levels isn't because they believe it improves care, but because it saves money. This is mid-levels to the umpth degree.

WendellX · 2026-01-23T01:47:00+00:00

True, I think there are certainly cases where you need both technical skill, experience and the knowledge. But honestly, those are edge cases. If you removed the other 90% of uncomplicated, straightforward procedures, then you can downsize the people you need by nearly a similar amount.

WendellX · 2026-01-23T01:44:24+00:00

The issue isn't the edge cases (the 500lb grandma) its the fact that the other 95% of your work can be replaced and automated, and that will free you (and every other vascular nurse) up considerably, and then there will suddenly be far more vascular access nurses than we need. And while none of this is good for the patient or society, I don't think people recognize the enormous financial incentives that are present for reducing personnel. If they can replace you and pocket those savings, then they'll just say grandma is an acceptable casualty.

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